“To Transfuse or Not to Transfuse”- A Neonatologist’s Perspective

The purpose of this short review article, is to reassess the definition and management of neonatal anemia, focusing on anemia of prematurity (AOP), and to suggest an algorithm for the approach to its management. Evidence based guidelines for the neonatal transfusions are still emerging. It is always a conundrum for a pediatrician and a neonatologist, to decide when to give packed red blood cells to a growing premature infant with or without signs and symptoms of chronic neonatal anemia. It is further complicated, as some of that clinical picture can be explained by co-morbidities like neonatal sepsis, apnea of prematurity and caffeine therapy. So, that physician needs to weigh the risks and benefits for such seemingly benign procedure and also rule out conditions that can mimic the signs and symptoms of anemia of prematurity.